NPIMap

Organization Active NPI

Gi Anesthesia, LLC

  • Anesthesiology Physician
  • Dayton, OH
National Provider Identifier
1730332610
Registry record updated Sep 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
GI ANESTHESIA, LLC
Practice address
4340 Clyo Rd Ste 200
Dayton, OH 45459-7000
Phone
(937) 534-7330
Fax
(937) 395-3682
NPI assigned
Oct 23, 2008
Last updated
Sep 8, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Joan Servis
Title
Credentialing Specialist
Phone
(937) 396-2602

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X Primary

Addresses

Primary practice location

4340 Clyo Rd Ste 200
Dayton, OH 45459-7000

Mailing address

4340 Clyo Rd Ste 200
Dayton, OH 45459-7000
Phone (937) 534-7330

Other identifiers 1

IdentifierTypeStateIssuer
2917115MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090217000157 OH Part B Supplier - Clinic/Group Practice 6002971553 Receives reassigned benefits from 45 practitioners
Practice locations: Dayton, OH

National Provider Directory

National Provider Directory

Locations

1530 Needmore Rd
Ste 101
Dayton, OH 45414
Phone (937) 396-2602

77 W Eleanor Dr
Ste 1
Springboro, OH 45066

Practitioners & affiliated clinicians

Practitioners 49

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 49

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1224720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757289600000",
    "number": "1730332610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4340 CLYO RD STE 200",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454597000",
            "telephone_number": "937-534-7330",
            "fax_number": "937-395-3682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4340 CLYO RD STE 200",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454597000",
            "telephone_number": "937-534-7330",
            "fax_number": "937-395-3682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GI ANESTHESIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-23",
        "last_updated": "2025-09-08",
        "certification_date": "2025-09-08",
        "status": "A",
        "authorized_official_last_name": "SERVIS",
        "authorized_official_first_name": "JOAN",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "937-396-2602"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2917115",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.